NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, School of Public Health, Hainan Medical University, Haikou, People's Republic of China.
Department of Population Health and Immunity, Walter and Eliza Hall Institute, Melbourne, Australia.
Malar J. 2024 Aug 13;23(1):242. doi: 10.1186/s12936-024-05063-1.
The effects of a diverse spectrum of malaria interventions were evaluated through a deterministic Plasmodium vivax transmission model. This approach aimed to provide theoretical evidence of the performance of these interventions once implemented for achieving malaria elimination.
An integrated intervention portfolio, including mass drug administration, insecticide treatment, and untreated bed nets, was analyzed through modeling. Additionally, data-driven calibration was implemented to infer coverages that effectively reproduced historical malaria patterns in China from 1971 to 1983.
MDA utilizing primaquine emerged as the most effective single intervention, achieving a 70% reduction in malaria incidence when implemented at full coverage. Furthermore, a strategic combination of MDA with primaquine, chloroquine, untreated bed nets, and seasonal insecticide treatments effectively eradicated malaria, attaining elimination at a coverage level of 70%. It was conclusively demonstrated that an integrated approach combining MDA and vector control measures is essential for the successful elimination of malaria.
High coverage of mass drug administration with primaquine and chloroquine before transmission was the key driver of the malaria decline in China from 1971 to 1983. The best-fit intervention coverage combinations derived from calibration are provided as a reference for malaria control in other countries.
通过确定性间日疟传播模型评估了各种疟疾干预措施的效果。这种方法旨在为一旦实施这些干预措施以实现消除疟疾提供理论依据。
通过建模分析了包括大规模药物治疗、杀虫剂处理和未处理的蚊帐在内的综合干预措施组合。此外，还进行了数据驱动的校准，以推断出在 1971 年至 1983 年期间能有效再现中国历史疟疾模式的覆盖率。
使用伯氨喹的大规模药物治疗成为最有效的单一干预措施，当全面覆盖时，疟疾发病率降低了 70%。此外，将 MDA 与伯氨喹、氯喹、未处理的蚊帐和季节性杀虫剂处理相结合的策略性组合有效地根除了疟疾，在 70%的覆盖率下实现了消除。结论表明，结合 MDA 和病媒控制措施的综合方法对于成功消除疟疾至关重要。
在传播前用伯氨喹和氯喹进行高覆盖率的大规模药物治疗是中国 1971 年至 1983 年疟疾下降的关键驱动因素。校准得出的最佳干预措施覆盖率组合可作为其他国家疟疾控制的参考。
